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Bin if
City of La Quinta
Building at Safety Division
P.O. Box 1$04, 78-495 Calee. Tampico
la Quinta, CA 92253 - (764). 777-7012
Building Permit Application and Tracking Sheet .
Permit #
A �
'Project Address: D
Owner'sNarne: py1 f
A. P. Numbor:
Address- 3
Legal Uescriptitut:
City, ST, Zip: ;hk C 4 .L 3
Contractor 0 Telephone: '
Address: >� l[CI ; 1 Projeot Description: �q 5�A &V M
City, ST, Zip: U of
Z.Z 2✓ 4 L �J_Y�/ g~&
Telephone: 6 p r D.
State Lie. # : 7
City Lie. #: 5' g'
Arclk., Etigr., Designer:
Address:
City; S•r, 'Lip:
1 eieplrune:
;fate Lic. #:
Constriction Type: Occupancy.
Projecttype (eircla one): New Add'n ,toter Repair Demo
Namc of Contact Person:
Sq. Ft.:
#Stories: # Units:
•1•ele Wne W of Contact Person:
Estimated Value of Project: S 0 o .
APPLICANT: DO NOT MUTE BELOW THIS UNE
ti
Submittal
Req'd Eked 'TRAMING _ PERMFr FEES
Plan (Meek submittled Item Amount
Plan Sets
Structural Cates.,
Reviewed, ready ror corrections Plan Check Deposit
Truss Cities.
Called Contact Person Plan Cheek Baia.ace
Energy Cates.
Mass aickcd up Construction .
Flood plain plan
Plans swabatitied Meekanical
Grading plan
2'i Review, ready for correctlons/lasut Electrical
Sabcontaclor Lis
Called Contact persan Plaat[ring
Grant Deed
Plan, picked up S.M.L
LI.O.A. Approval
PIaa3 resrtbiumed Grading
IN HOUSE:-
�"'ttevl.ew, ready for correctionalissue Developer impact Fee
Planning Approval
Called Contact Person
Pub. Ms. Appr
Date of permit Issue.
ScGool Fees
_... _ ..
Total Permit Fees
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVACAIterations CF-IR-ALT-HVAC
Climate Zones 10 - 15
Site Address: Enforcement Agency: Date: Permit #:
79100 Big Horn Trail La Quinta, CA 92253 City of La Quinta I May 8, 2013
Duct insulation Conditioned Floor
Equipment Type1 List Minimum Efficiency2 requirement Area Thermostat
❑ Package Unit
[3 Furnace [3 AFUE ❑ COP [3rR 6 (CZ 10-13) Served by system f setback
Indoor Coil [3 SEER [3HSPF not already present, must be
®
[3 Condensing Unit [3EER ❑ Resistance [3 R 8 (CZ 14-15) 16UQ sf installed)
❑ Other
1. Equipment Type: Choose the equipment being installed; if more than one system, use another CF-IR-AZT-HVAC for each system.
2. Minimum Equipment Efficiencies: 13 SEER, 78% AFUE, 7.7HSPF for typical residential systems.
HERS VERIFICATION SUMMARY Listed below are FOUR HVAC alteration Options. The installer decides what work is being done
and picks one of the appropriate Options. Each Option lists the HERS measures that must be conducted. A copy of the forms shall
be left on site for final inspection and a copy given to the homeowner. At final, the inspector verifies that the work listed on this
form was in fact the work completed by the installer, The inspector also verifies that each appropriate CF-6R and registered CF-4R
forms (no hand filled CF-4Rs allowed) are filled out and signed.8eginning October 1, 2010, a registered copy of the CF-111
and CF-611 shall also be on site for final inspection.
1. HVAC Changeout Required Forms:
All HVAC Equipment CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
replaced CF-4R forms: MECH-21 and (for split systems) MECH-25
. Condenser Coil and /or CF-6R forms: MECH-04, MECH-2I-HERS and (for split systems) MECH-25-HERS
. Indoor Coil and /or CF-4R forms: MECH-21 and (for split systems) MECH-25
• Furnace
For Split Systems: Duct leakage < 15 percent; RC, CCA <_ 300 CFM/ton (Minimum Air Flow Requirement), TMAH
Exempted from duct leakage testing if:
❑ 1. Duct system was documented to have been previously sealed and confirmed through HERS verification, or
❑ 2. Duct systems with less than 40 linear feet in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. The system will not be Ducted (ie. Ductless Mini -Split System) (Also Exempt from Refrigerant Charge)
❑ 2. New HVAC System , Required Forms:
. Cut in or Changeout with CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-22-HERS, and
new ducts: (all new MECH-25-HERS
ducting anc1 all new CF-41k forms: MECH-20, and (for split systems) MECH-22, and MECH-25
equipment)
For Split Systems: Duct leakage < 6 percent; P.C, CCA >_ 350 CFMiton, FWD, TMAH, STMS, and either HSPP or PSPP.
For Packaged Units: Duct leakage < 6 percent
❑ 3. New Ducts with/or without Required Forms:
Replacement
. Includes replacing or installing all new
ducting and/or outdoor condensing unit CF-6R forms: MECH-04, MECH-20-HERS, and (for split systems) MECH-25-HERS
and/or indoor coil and/or furnace. No or some CF-4R forms: MECH-20 and (for split systems) MECH-25
equipment changed.
For Split Systems: Duct leakage < 6 percent; RC, CCA ? 300 CFM/ton, TMAH
For Packaged Units: Duct leakage < 6 percent
❑ 4. New Ducting over 40 feet lRequired Forms:
. Includes adding or replacing more than 40 CF-6R forms: MECH-04, MECH-2I-HERS
linear feet of duct in unconditioned space. 1CF-4R forms: MECH-21
For split system or packaged units: Duct leakage < 15 percent
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
Contractor (Documentation Author's /Responsible Designer's Declaration Statement)
. I certify that this Certificate of Compliance documentation is accurate and complete.
. I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this Certificate of
Compliance.
. I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations.
e The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable compliance
forms, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with the permit application.
Name: Gary Laster 1 Signature: Gary Laster
Company: DOVE AIR INC
Address: 68-749 RISUENO ROAD
p: CATHEDRAL CITY / CA / 92234
Date: May 8, 2013
License: 794315
Phone: (760) 327-1890
Reg: 213-A0027844A-oo0000000-0000 Registration Date/Time: 2013/05/08 19:09:09 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms July 2010